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What Do I Do If My Employer Refuses to Pay My Workers Compensation Claim?

Standing up to an employer can be intimidating. Know your rights.

If you have been injured on the job, you are probably counting on workers’ compensation benefits to pay necessary medical expenses and other bills. It’s scary when you can’t work, expenses are mounting, and your employer won’t pay you benefits you are owed. The workers’ compensation system can be very complicated and difficult to navigate. Learn about what happens if your employer denies your workers’ compensation claim.

My employer refuses to pay my workers’ compensation claim. What can I do?

Whether it be your employer or your employers’ insurance company denying your workers’ compensation claim, you are still left without compensation you count on to pay living expenses and medical expenses you may have incurred due to your workplace injury. Workers compensation benefits include medical benefits and wage replacement benefits such as:

  • Temporary total benefits
  • Temporary partial benefits
  • Permanent impairment benefits
  • Permanent total benefits
  • Death benefits

The insurance company must deny the claim within 120 days from the date the injury or illness was reported. The most common reasons for denial of a workers’ compensation claim include:

  • The claim was not reported or filed on time.
  • The employer disputes that the accident happened at work.
  • The employer disputes that your injury or illness was the result of a workplace accident.
  • Your medical condition is not covered by workers’ compensation.
  • Your injuries are not severe enough to be covered.

Your claim denial letter should state the reason your claim is being denied. If you feel your claim was wrongly denied, a Petition for Benefits form must be filed with the Office of Judges of Compensation Claims to start the judicial process. You will not be provided with an attorney, but your employer or their insurance company may be held responsible for paying your attorney’s fees should you choose to hire counsel.

The insurance company must pay the claim or respond to the petition with 14 days of receiving it. If the insurance company still denies the claim, mediation will be held within 130 days of filing the petition. If nothing is settled at mediation, the dispute will be heard before a workers’ compensation judged, proceed to pre-trial hearing and a final hearing will be held within 90 days after the pre-trial hearing. A decision will be made by the workers’ compensation judge and, if you contest that decision, you must file an appeal within 30 days of the judge signing the order.

Employers and their insurance companies count on you not pursuing your legal rights, so they don’t have to pay legitimate workers’ compensation claims. Attorney Joe Rooth of the Rooth Law Firm is a Board Certified Florida workers’ compensation attorney. Attorney Rooth aggressively pursues your claim against your employer or their insurance company to obtain the workers’ compensation benefits you deserve. With more than 25 years of experience and a well-earned reputation for success, Attorney Rooth is the legal counsel you need on your side. If your employer or their insurance company has refused to pay you, contact the Rooth Law Firm at (727) 849-3400 or online today for a free consultation.

roothlawyerWhat Do I Do If My Employer Refuses to Pay My Workers Compensation Claim?